Individual provider Active NPI

Raphaelle D. Vallera, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Dallas, TX
National Provider Identifier
1790777365
Registry record updated Feb 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
K1711 Issued in TX
Practice address
3417 Gaston Ave
Suite 980
Dallas, TX 75246-2016
Phone
(469) 800-8020
Fax
(469) 800-8030
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X K1711 TX
Endocrinology, Diabetes & Metabolism Physician 207RE0101X K1711 TX Primary

Addresses

Primary practice location

3417 Gaston Ave
Suite 980
Dallas, TX 75246-2016

Mailing address

3417 Gaston Ave
Suite 980
Dallas, TX 75246-2016
Phone (469) 800-8020

Other identifiers 6

IdentifierTypeStateIssuer
900003262OtherTXRAILROAD MEDICARE
15857566OtherTXPACIFICARE
4242788002OtherTXCIGNA
031518601MedicaidTX
1420298OtherTXUNITED
5487391OtherTXAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041004000461 TX Practitioner - Endocrinology 6901865229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Hahnemann University College of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

200 N Virginia St
Baylor Scott and White Fam Med Ctr Terrell
Terrell, TX 75160-2732
Phone (469) 800-3100

400 W Lyndon B Johnson Fwy
Irving, TX 75063-3700

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021
  • Baylor Scott & White Medical Center Plano Hospital, Plano, TX, CCN 450890
  • Baylor Scott and White Medical Center Lake Pointe Hospital, Rowlett, TX, CCN 450742

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Mar 24, 2014 Accepting new patients
Healthtexas Provider Network Endocrinology, Diabetes & Metabolism CurrentSince Mar 24, 2014 Accepting new patients
Howard J Heller MD PA Endocrinology, Diabetes & Metabolism Past Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

3417 Gaston Ave
Ste 980
Dallas, TX 75246
Phone (469) 800-8020

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

8080 N Central Expy
Ste 600
Dallas, TX 75206
Phone (972) 860-8648

Interoperability endpoints

  • Direct secure messaging: rvallera226145@direct.sw.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487030400000",
    "number": "1790777365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE",
            "address_2": "SUITE 980",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462016",
            "telephone_number": "469-800-8020",
            "fax_number": "469-800-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3417 GASTON AVE",
            "address_2": "SUITE 980",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462016",
            "telephone_number": "469-800-8020",
            "fax_number": "469-800-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLERA",
        "first_name": "RAPHAELLE",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2017-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "K1711",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "K1711",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "900003262",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PACIFICARE",
            "identifier": "15857566",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4242788002",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "031518601",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED",
            "identifier": "1420298",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5487391",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.